Consequences after tubal ligation in women. Sterilization as a method of contraception. How effective is such an operation?
Modern medicine and pharmacology make it possible to determine for yourself the appropriate method of contraception during sexual intercourse. You can choose the appropriate method of protection from medication to surgery. However, some types of contraception can have irreversible effects on the body. This type includes female sterilization, namely tubal ligation.
Tubal ligation as a type of female sterilization
Tubal ligation is performed through surgical intervention. As is known from the general concepts of human anatomy, the fallopian tubes play an important role in fertilization. After maturation, the egg begins to move towards the fallopian tubes. In the case of sexual intercourse, sperm also move towards the egg through the fallopian tubes, where the zygote (fusion) occurs. So if the integrity of the tubes is compromised, fertilization of the egg will not occur.
There are several ways (methods) of tubal ligation:
- Vaginal. With this method, tubal ligation occurs through the vagina. The operation takes place under general anesthesia. This species has two significant drawbacks: inaccessibility and the possibility of infection. Along with the fact that performing the operation this way does not leave external scars, there can be much worse consequences. With this method, the doctor acts mainly based on his feelings. In addition, in addition to the possibility of infection, the internal walls of the vagina are greatly damaged.
- Laparotomy. It is a safer method, and also makes it possible to clearly see the processes taking place. The dressing passes through an incision in the lower abdomen. After the operation, a scar remains, but modern medicine and cosmetology can help get rid of it or make it less noticeable.
- Endoscopy. The necessary access to the fallopian tubes occurs through the area around the navel. The operation is performed by cauterizing the tubes.
Using the above methods, tubal ligation itself is also carried out in several ways. The method is determined in each individual case individually, according to the doctor’s instructions.
These methods include:
- applying medical clips that compress the fallopian tubes;
- cauterization with preliminary cutting of the tubes;
- cutting of pipes with ligation of the formed ends;
- clamping (tying) without cutting.
Advantages and disadvantages of this type of female sterilization
As a rule, a woman has good reasons for agreeing to such a procedure. After all, only with tubal ligation without circumcision is there a chance of their restoration. In this case, the possibility of getting pregnant will be minimal.
Most often, women agree to such an operation if they have two or more children. In this case, without planning to add to the family, the woman decides to undergo a similar procedure. In some cases, tubal ligation is a doctor's order. Such cases include medical contraindications or the presence of a chromosomal disease, which is dangerous because it can be transmitted to the child.
This type of sterilization, of course, has its advantages:
- As a method of contraception, tubal ligation gives 100% results. After the operation, pregnancy is excluded, so there is no need to use protection during sexual intercourse.
- The woman’s hormonal levels will not change at all and there will be no side effects such as diseases of the female genital organs or the appearance of excess weight.
- Sexual desire does not disappear, menstruation does not radically change its cyclicity.
- The procedure can be performed immediately after childbirth or after a cesarean section. Does not require special preparation of the body for surgery.
- Will not change the woman's general health.
Despite a number of advantages, like any intervention in the integrity of the body, tubal ligation has its disadvantages, which are largely related to the quality of the operation performed.
- Postoperative complications such as weakness, vomiting and dizziness may occur.
- Infection.
- If desired, it will not be possible to become pregnant and carry a child.
- If doctors are negligent during an operation, an ectopic pregnancy is possible, which is accompanied by complications and loss of the child.
Negative factors are most often associated with the human factor and individual characteristics of the body.
Consequences of tubal ligation
Any surgical intervention in the body has both irreversible consequences and the ability to restore all body functions. If we talk about the consequences of this type of sterilization, then it is necessary to understand that there are irreversible consequences of this operation, and there is a range of possible consequences.
Irreversible consequences include the absolute inability of a woman to become pregnant naturally. Only in the case of tubal ligation by tying or applying clips is it possible to restore their integrity and function. However, the chance of getting pregnant will be minimal. This type of sterilization completely deprives a woman of the ability to conceive and bear a child. This fact can be attributed both to the consequences of the operation and to its immediate purpose. After all, bandaging is done so that pregnancy does not occur again.
There is always a possibility of infection and side effects. Especially with the vaginal method of tubal ligation, vessels are often damaged, inflammation occurs, and in some cases bleeding. All this will negatively affect the body’s recovery process after surgery and will require additional treatment.
In addition, a normal allergic reaction of the body can always occur. An allergen can be either anesthesia (narcosis) or any medicine that is used during the recovery process of the body after surgery. But all this can be attributed rather to possible consequences, since they will depend directly on the conscientiousness and responsibility of doctors, as well as on the individual characteristics of the body.
Consequences of tubal ligation: sepsis, vascular ruptures, bleeding, anaphylactic shock from anesthesia during surgery, inflammatory processes, a small percentage of unwanted pregnancies (6 out of 1000 women still get pregnant after tubal ligation).
Features of tubal ligation in women
Tubal ligation for a woman it is considered one of the reliable ways to protect against unwanted pregnancy. This is a kind of sterilization method that is performed through surgery. If done correctly, tubal ligation will forever eliminate the possibility of pregnancy. Tubal ligation is recommended in certain situations. So, this procedure is relevant when a woman cannot bear a child safely for her health. Also, this method of irreversible contraception is used in the presence of contraindications in the use of oral medications, spirals. Very often, women undergo tubal ligation when they voluntarily refuse to have children.
The purpose of this method of contraception is to achieve artificial obstruction of the fallopian tubes. As a result, sperm will have no opportunity to meet the egg and then fertilize it.
"Female sterilization" has its own legal nuances. Thus, the woman needs a mandatory legal agreement for this operation, signing a number of different documents. After a woman contacts a medical institution with her desire to have a tubal ligation, a certain time is allotted for reflection (to carefully consider her decision). When the allotted time has passed and the woman agrees to the operation, she will need to sign an official document - an agreement. Such documents have legal force.
Tubal ligation methods
There are several methods for tubal ligation. Can do: bandaging and circumcision; tying or applying special staples; circumcision and cauterization.
There are such types of surgical intervention:
- — laparoscopy, aparotomy (surgery of the abdominal cavity);
- — endoscopy of the uterus followed by the application of special plastic micro-tampons;
- - colpotomy (the so-called vaginal method).
All these operations are performed under anesthesia. They are not very long in duration - about half an hour. A few days after the operation, the patient is already discharged home. Experts assure that the risk of complications after these operations is minimal. And only in quite rare cases can any side effects occur. We will look at this issue in more detail.
Side effects after tubal ligation in women
Whatever doctors say about the minimal risks of side effects and consequences of tubal ligation, in practice many face various problems. Those who have undergone such an operation say that immediately after it there may be severe weakness and even temporary pain. You may also experience dizziness, cramping (which resemble period pain), and bloating. Nausea often occurs. All this can be attributed to the side effects of the female body’s reaction to anesthesia and surgery.
After tubal ligation, normally no special changes are observed in the body of women. There is no weight gain when comparing this method of contraception with hormonal contraceptives. A woman’s libido (sex drive) also remains normal. As for hormonal changes, they do not occur. And all due to the fact that female hormones, as before, are produced by the fair sex. Also, after the operation, the menstrual cycle is not disrupted. He basically remains the same as he was before. If a woman decides to undergo tubal ligation, then she must clearly understand that she will no longer be able to have children. This method of protection is considered irreversible.
Consequences of tubal ligation in women
As sad as it may sound, sometimes tubal ligation operations are not very successful. Some stages of the operation may be performed incorrectly or poorly. Because of this, a woman can have very dire consequences. For example, sepsis may develop. The integrity of blood vessels may also be compromised (vascular rupture). Sometimes, after a tubal ligation, a woman suddenly begins to bleed. It is also not necessary to exclude the possibility that a woman may experience anaphylactic shock from anesthesia. The consequences of tubal ligation operations include the possibility of developing various inflammatory processes. If the tubal ligation was performed incorrectly, the woman will be able to become pregnant.
According to statistics, after this procedure, 6 women out of 1000 still get pregnant.
As you can see, all of these listed consequences are very serious in themselves. And some women, after undergoing tubal ligation surgery, suffer from a whole “bouquet” of such consequences. It is believed that tubal ligation is fundamentally different from other methods of contraception: after this procedure, a woman’s reproductive function is completely and forever eliminated. But in world practice, there are women who gave birth to children even after tubal ligation. Of course, the percentage of such women is very small. It is almost impossible to get into his number. Therefore, it is necessary to remember this fact always. It is not difficult to perform an operation, but dealing with the consequences can be very difficult.
To avoid dire consequences after tubal ligation surgery, it is recommended to carefully plan this procedure, find out the necessary information, compare reviews, take into account the reputation of the clinic, and the experience of certain doctors. It is best to perform this operation in inpatient clinics. You should also unconditionally follow all doctors’ recommendations regarding the rehabilitation period.
Reviews about tubal ligation
Statistics are one thing. But what women say after tubal ligation surgery is much more interesting. There are a lot of reviews. Of course, there are a huge number of women in the world who are satisfied with the chosen tubal ligation procedure. They respond well to this operation because they no longer have to worry about whether an unplanned pregnancy will occur. Their head no longer hurts about how to protect themselves. Some indicate that their husbands are now very happy, since they no longer need to use the additional protection of . After all, as you know, almost no one likes sex with a condom.
Someone speaks out in favor of tubal ligation surgery, since after it the libido remains in order. Not everyone can boast of this fact while taking oral contraceptives. As you know, hormones greatly reduce libido. After the operation, women do not have problems with desire. Among the reviews you can find those in which women praise the operation precisely because of the material aspect. In the future, they will no longer need to spend extra money on contraceptives, which nowadays are not very cheap.
Among the reviews about tubal ligation, you can find a lot of negativity. Many people say that this is still a surgical intervention, which has a high risk of postoperative complications. After the operation, some experienced severe bleeding, some developed adhesions, and some experienced sepsis. Some even managed to get pregnant and give birth to an unplanned child. As you can see, there are a lot of reviews: both bad and good.
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At the moment, surgical tubal ligation - abbreviated as PMT - is considered the most effective and efficient contraception. In what cases is this type of contraception practiced and to whom is it contraindicated, and how is it carried out? Let's look at all the pros and cons of tubal ligation.
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Why is tubal ligation done?
At its core, PMT is a surgical intervention in a woman’s reproductive system and blocking it by ligating or clamping, cutting the fallopian tubes and creating an artificial obstruction.
To put it simply, this is female sterilization, irreversible in nature, to prevent conception and pregnancy.
Pros and cons of dressing
The main advantage of PMT for a woman is the opportunity to have an active sex life and not be afraid of an unwanted pregnancy. In addition, doctors and women themselves highlight the following points:
Regarding the disadvantages of this procedure:
- There are many complications after PMT - inflammation and bleeding, which are caused by infection and sepsis. Such consequences often occur during tubal ligation during cesarean section.
- Female type infertility is irreversible, and if the technology is violated, the risk of developing an ectopic pregnancy increases.
- The need to use anesthesia - not every woman tolerates anesthesia well, which complicates the choice of contraception.
Indications for the procedure
PMT is performed on all women over 35 years of age who have children of their own and do not want to become pregnant or give birth again in the future. It is also carried out when diagnosing pathologies that can aggravate the course of pregnancy, cause spontaneous miscarriage or the birth of a child with pathologies. The cause and basis is the diagnosis of a disease that can be transmitted to a child at the genetic level and in the absence of pathologies that make the operation itself impossible. Last but not least is the threat to a woman’s life that pregnancy can pose to her.
Contraindications
Doctors include a diagnosed inflammatory process occurring in the pelvic organs and obesity, as well as identified benign/malignant tumors and strong adhesions in the cavity of the pelvic organs as absolute contraindications to ligation.
Also, PMT can be postponed for a while due to severe, general diseases and inflammatory processes, which make the use of anesthesia and surgical intervention impossible.
Rules for preparing for surgery
The rules for preparing for dressing include a number of examinations. This is a blood donation for testing - HIV and coagulation, as well as an examination by a gynecologist, fluorography and ECG, ultrasound. This will allow us to determine the general condition of the reproductive system and the woman’s condition in general, select the optimal option for surgical intervention and eliminate all negative consequences.
Tubal ligation is performed using several methods:
- Laparoscopy- the safest of all methods of performing PMT, which is carried out in an outpatient setting and using local anesthesia. Injuries during this procedure are minimal, no scars are left on the skin, and the rehabilitation period is about a week.
- Laparotomy — in this case, the dressing is done after a caesarean section.
- Minilaparotomy — The method is applicable after childbirth, when surgery is performed in the first days after delivery. Performed through laparoscopy. The procedure is also classified as low-traumatic.
- Colpotomy- it is carried out in a hospital, when access to the fallopian tubes is carried out through the rectum, then the uterine space. The advantage of surgical intervention is that it is affordable and there is no scarring; there is no need to use expensive equipment.
Minus - the recovery period takes about 1-1.5 months, there is a high probability of infection.
- — dressing is performed using a hysteroscope inserted through the cervical canal. The method is not widely used due to the high percentage of complications and low efficiency.
Consequences of the procedure
Regarding possible complications, doctors identify early and late negative consequences after PMT:
- Doctors include internal bleeding and intestinal damage, as well as the development of sepsis, as early negative consequences.
- Doctors include hormonal imbalances and menstrual cycle disturbances, ectopic pregnancy and mental problems as later negative consequences.
In addition, in both cases, the development of necrosis and other negative consequences is possible, regardless of the method of surgical intervention.
Cost of the operation
The cost of tubal ligation using laparoscopy or another method ranges from 9 to 80 thousand rubles; if it is carried out simultaneously with a cesarean section, the cost will vary from 22 to 54 thousand rubles.
While some women are unable to get pregnant, others become pregnant at the most inopportune moment. Trying to find an effective method of contraception, some of them agree to voluntary surgical sterilization (VS). Is the decision to give up the joy of motherhood always justified? What is the meaning behind the medical term “tubal ligation”? What are its consequences? Many questions arise in the minds of women, which most find it difficult to answer.
Fertilization of a mature egg occurs in one of the two fallopian tubes. It enters it from the ovary. With the help of muscle contractions and the movements of numerous cilia lining the inner walls of the tube, the egg rushes towards the sperm. If the passage is blocked, then it remains in the cavity of the pipe and then resolves. The same outcome awaits the sperm.
Sterilization is based on the principle of creating an insurmountable obstacle to the union of male and female reproductive cells. It is designed to prevent pregnancy by preventing the flow of sperm from reaching the egg. The surgical methods used for this purpose differ in the methods of access, the types of blockers used and provide an almost 100 percent guarantee of contraception.
After tubal ligation, pregnancy can be said to be excluded. It occurs no more often than in 0.5-1.5% of cases. If a woman does not have an alternative method of contraception, then bandaging will solve the problem. Once and, most likely, forever, because after a while it becomes almost impossible to untie the pipes.
A look at the procedure from a legal point of view
How serious the issue is can be judged by the fact that medical sterilization is comprehensively described in Law No. 323 of November 21, 2011 “On the protection of the health of citizens of the Russian Federation.” Article 57 is dedicated to it, the essence of which boils down to the following:
- The basis for the procedure is a written application.
- It is not necessary to have medical indications for sterilization.
- If there are no medical indications, then one of the indispensable conditions must be met - to reach the age of 35 years or have two children. If there are medical indications, these requirements do not need to be followed.
- Medical indications are listed in the list attached to the article.
- For incompetent persons, sterilization is carried out on the basis of a court decision.
The law opens the way for many who wish to use sterilization, but at the same time, a warning can be read between its lines. A woman’s ability to reproduce is lost forever, so before you take a step, you should think very, very carefully about your decision.
Not the last role is given to doctors. They must study the current circumstances and explain to the woman that she will never be able to get pregnant after this. If the decision is made positively, then the relevant documents are signed.
When is it necessary and why should it not be carried out?
Doctors believe that sterilization is necessary when a woman suffers from one of the following ailments:
- Cardiovascular disease;
- Severe form of diabetes mellitus;
- Pulmonary hypertension;
- Leukemia;
- A dangerous disease that is inherited;
- Active form of hepatitis;
- Liver failure.
In addition, it is also worth resorting to tubal ligation if the birth of two or more children occurred via cesarean section. In all these cases, the woman's health and life will be at risk if she has to become pregnant again. She will not be able to carry the pregnancy, and the risk is not worth it.
Contraindications for DHS are:
- Oncological diseases;
- Obesity;
- Inflammatory and adhesive processes in the reproductive system;
- Allergy to the anesthesia used;
- Age up to 35 years.
Single women or those with unstable family or sexual relationships should not undergo tubal ligation. In the future, they will be deprived of fertility, and if circumstances change, the desired pregnancy will not occur. It is more acceptable for them to find other methods of contraception.
What access methods are used?
The tubes are tied using various methods of surgical operations. Laparoscopy is considered the most gentle. It leaves two invisible scars. For laparoscopy, you can contact any medical institution that has the appropriate equipment. Tubal ligation is performed under general anesthesia. Since the operation is minimally invasive, you can return home the same day and continue your normal lifestyle a week later. After childbirth or cesarean section, at least 6-8 weeks should pass.
Laparotomy (open surgery) is done under general anesthesia. If the birth is planned using a cesarean section, then sterilization is carried out at the same time. A mini-laparotomy proceeds in a similar way, with the difference that it is performed on an outpatient basis under local anesthesia.
An operation such as colpotomy does not leave any scars because the posterior wall of the vagina is used for access. It can only be carried out in a hospital. At the same time, the most cases of infection are observed with it, so colpotomy is almost never used. Sexual contacts after it are prohibited for one to one and a half months.
How is tubal ligation performed?
For whatever reason, the operation is performed, its main goal is to ensure that the woman cannot become pregnant after it. Whether it is the testimony of doctors or the decision is made personally, it does not matter. The methods used are divided into several types:
- The tubes are tied using suture material. One method involves forming a loop from the pipe and then fixing it. In another case, ligation is performed in two places, and the area between them is excised.
- Blocking (occlusion) is carried out using various clips, clamps, and silicone rings. The pipe is slightly injured, which later makes it possible to restore its patency.
- The coagulation method involves sealing the tube with a laser or a special electrosurgical instrument at a distance of 3 cm from the uterus.
- The introduction of chemicals is used to remove the plugs.
- The blockage is performed with implants inserted into the tubes through the uterine cavity.
The technique is selected taking into account the capabilities of the medical institution and the experience of the gynecological surgeon. The most unpleasant consequences are medical errors. They usually end in pregnancy.
Behavior before and after surgery
If you have to undergo DHS, then all recommendations are given by the doctor. He prescribes a medical examination and decides which medications need to be temporarily discontinued in order to eliminate undesirable consequences. All medications should be stopped a week before dressing. The reasons that prompted her to choose sterilization as a method of contraception must be discussed with the patient.
It is necessary to take a pregnancy test the day before to exclude its presence. If the result is positive, the operation is postponed. You will have to choose whether to continue the pregnancy or have an artificial termination. It is not recommended to eat or drink immediately before surgery.
Arriving home, you should avoid physical activity in the first days and do not drive. You can take a shower (but not a bath!) after two days, being careful not to wet the wounds. Infection in them can have dangerous consequences in the form of inflammation or suppuration. Having sex should be postponed for 7-10 days.
Compliance with the instructions will help you undergo rehabilitation faster. After 4-6 weeks, periods return to normal. After 2 weeks, you should make an appointment with your doctor.
Complications after DHS
Serious consequences are rare after tubal ligation. Usually this:
- Bleeding;
- Inflammatory processes caused by infection;
- Allergic reaction to anesthesia;
- Damage to internal organs located near the tubes, if the operation was not performed after a cesarean section;
- Incorrect insertion of implants, which can result in pregnancy.
Women are always interested in how long it takes to fully recover. It’s difficult to give an exact answer, because some people feel great after a few days. Others require 2-3 weeks for rehabilitation.
Laparoscopy and mini-laparotomy, as a rule, proceed without side effects. If you are still bothered for a long time:
- Severe abdominal pain
- Heavy bleeding
- Swelling of the legs,
- Temperature increase,
- Continuous nausea and vomiting
- Dizziness and fainting,
then a visit to the doctor should be made immediately. Only a doctor will be able to establish the true cause of the ailments and take immediate measures to eliminate them. You need to be especially careful if there were medical indications for sterilization.
Where is DHS held and how much does it cost?
The tubal ligation procedure can be performed both in private clinics that have a license for it, and in government institutions. From this follows the answer to how much you need to pay for the operation. If there are medical indications for sterilization, you can use the services of a municipal institution. All expenses will be covered by the compulsory medical insurance policy.
The cost in private clinics is influenced by many factors, but in general, sterilization is always expensive. What matters is the method used, the qualifications of the specialist, the status of the medical institution, the region and city in which it is located. The price range reaches significant values, so in each specific case the cost is determined individually.
The only consolation is that the costs are one-time. In the future, no costs for contraception are expected. Therefore, no matter how much you have to pay, it is important to get a good result and not have such a side effect as an ectopic pregnancy.
All the pros and cons of DHS
When deciding on tubal ligation, you should remember that this process, like any other, has two sides: dark and light. Its advantages are significant:
- In 99 percent of cases, pregnancy does not occur;
- The risk of developing cancer in the ovaries is reduced by 39%;
- Hormonal levels do not change, and this means that weight does not increase;
- A woman gains psychological balance because she is no longer bothered by the fear of becoming pregnant;
- Against this background, sexual relations develop: they become freer and more relaxed.
It would seem that everything is fine, if not for those disadvantages that spoil the good impression of the DHS. The first and most important thing is that you will never be able to get pregnant again. In addition, the percentage of women in whom conception occurs as a result of medical errors and restoration of tubal patency after a certain period of time. The chance of developing an ectopic pregnancy increases 3 times! If the reason for DHS was medical indications, then these are very dangerous consequences.
The sad irreversibility of DHS
The advantages and disadvantages of sterilization can be debated endlessly. A woman has a difficult choice to make, because there is one very important aspect. Tubal ligation is a virtually irreversible process. If, over time, the need arises to untie the pipes, then you need to be prepared for the fact that operations to restore patency are only 30-70% effective. Most sterilized women are no longer able to become pregnant naturally.
The only option left is IVF. The procedure is expensive and does not always give results the first time. Recanalization is also not affordable for everyone. They don’t do it for free, and the cost, depending on the clinic, ranges from 7-10 thousand dollars. Ultimately, you can say goodbye to the desire to have a child forever.
It is impossible to foresee all the twists and turns of fate. What seems right in youth is greatly questioned in adulthood. When deciding to sterilize, you need to realistically assess the current circumstances. There are many methods of contraception. With the development of medicine, their number is constantly increasing. So isn’t it better to choose one of them and not deprive yourself of what is given to a woman by nature - to be a continuator of life?
Situations often arise when, for one reason or another, a woman does not want to have children. We are not talking about classical methods of contraception, if canceled, pregnancy will occur, but about sterilization, when it will no longer be possible to give birth in the future. One of these methods of female sterilization is tubal ligation, the pros and cons of which we will reveal in our article.
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The fallopian tubes are the place through which the egg moves after maturation and release from the follicle. In addition, it is there that fertilization occurs and the further movement of the embryo into the uterine cavity with its subsequent attachment to the wall. Impairing the patency of the tubes by ligation is considered one of the most reliable methods of contraception, which almost 100% protects against unwanted pregnancy.
It is not necessary to have any pathologies or diseases to perform such an operation. In most cases, this is done by completely healthy women who have decided that they will not give birth to children. These are not only childfree people who are categorically against children, but also women who already have one or more. Also, a woman may undergo tubal ligation due to the presence of certain health problems that make it risky to give birth to children. It could be:
- serious heart defects, vascular diseases;
- diabetes;
- genetic hereditary diseases;
- malignant tumors;
- pathologies of the lungs, kidneys and others.
Often, tubal ligation is done during a cesarean section, if any problems or pathologies arise during the first pregnancy, which make it clear that further childbirth may be life-threatening for the mother.
Main types of dressings
Pipes can:
- cut;
- bandage;
- seal by soldering.
The most common techniques used for tubal ligation are:
- laparotomy;
- minilaparotomy;
- laparoscopy.
Depending on the chosen method, the cost may vary.
The main advantage is a 100% guarantee that pregnancy will not occur. But this is also the main disadvantage, because the process is almost irreversible. This means that the woman who has undergone the dressing will not be able to do so if she changes her mind and decides to have another child. In rare cases, the patency of the tubes can be restored through surgery, but this is very difficult. The only way to get pregnant is IVF. But this procedure does not provide a 100% guarantee, because it may not work the first time.
Consequences of the operation
If everything is in order, there will be no negative consequences after tubal ligation, except that the woman will lose her reproductive function. This is a mechanical surgical intervention, so there are no negative effects on the body. There is no hormonal disruption, as, for example, often happens when taking oral contraceptives. Also, this procedure does not affect a woman’s libido in any way. Therefore, in general, everything will be the same as before, except that pregnancy will not occur even with unprotected intercourse. Of course, this does not mean that a woman can sleep with different partners, change them often and not use protection. No, the number of partners is her personal business, but if she is not sure about him, that he is healthy, it is better not to take risks and use a condom so as not to pick up anything.
How much does tubal ligation cost?
The cost of tubal ligation surgery varies, depending on the city in which it is performed, in a public or private clinic, and what method is used. Prices for tubal ligation vary between 4,000 – 50,000 rubles. In some public medical institutions, this procedure can be performed free of charge using a compulsory health insurance policy. Also, do not forget that this is a surgical intervention, before which it is necessary to undergo a series of tests, which are also paid in most cases. Prices can be found in advance on the websites of selected clinics. But, it is better to focus not only on the cost, but also on the reputation of the institution itself, doctors, and patient reviews.